Medication dispensing and monitoring system

ABSTRACT

A medication dispensing and monitoring system includes an acknowledge-back pager, a carriage communicating with the pager, and a medication unit dispensing stored medication. The pager receives prescriptions and transmits messages back to a physician or health care organization. Prescriptions received by the pager are stored and processed by a pager processor. The pager processor communicates with a carriage controller via a series of electrical contacts. At a prescribed time, a motor in the carriage causes the medication unit to dispense the prescribed medication. Numerous medication units may be assembled to accommodate different forms of medication.

BACKGROUND OF THE INVENTION

[0001] 1. Field of the Invention

[0002] The present invention relates to systems and methods formedication dispensing and monitoring. More particularly, the presentinvention is directed to systems and methods for patient medicationcompliance assistance and monitoring.

[0003] 2. Background

[0004] Each year, numerous patients are admitted to hospitals forcomplications resulting from medication non-compliance. Statisticsindicate that over one-third of elderly patients admitted to hospitalsare admitted due to some form of medication non-compliance. Among themost frequently cited reasons for non-compliance are failing to take theproper medication or combination of medications, administering theincorrect dosage, and forgetting to take the medication altogether. Forcertain minor illnesses, failing to take medication may result in milddiscomfort that may be treated on an outpatient basis. For more seriousillnesses, however, medication non-compliance can result in long-termhospital care and/or death.

[0005] In addition, failure to follow a prescribed treatment ultimatelymay make the virus or bacteria resistant to treatment and create apotential health risk by creating drug-resistant strains of the disease.Human Immunodeficiency Virus (“H.I.V”) infection is one example of anillness requiring strict adherence to prescribed medications.Unfortunately, adhering to a typical H.I.V. drug regimen is often easiersaid than done. For instance, in a recent article, one patient describedhis daily medication schedule as follows: At 8:30 a.m., the patient musttake two pills of Crixivan. At 10:30 p.m., the patient takes one pilleach of Zerit, Epivir, and Blaxin. At 2:30 p.m., he must take one pilleach of Prednisone, Zovirax, Bactrim, and a prescribed multivitamin. At4:30 p.m., the patient takes two additional Crixivan pills. At 10:30a.m., he takes one pill each of Zerit, Epivir, and Biaxin. Finally, at12:30 a.m., the patient must take two more Crixivan pills. In addition,certain pills must be taken with food while other pills may not be takenwith food. Needless to say, following such a complicated drug regimencan be a difficult task.

[0006] One cause of medication non-compliance are drug labels that aredifficult to read, particularly for those with vision problems. Althoughthe label print size may be increased, even large-print labeling doesnot improve compliance if the patient forgets the overall drug regimen.Acknowledging the problems of non-compliance and poor labelling, somephysicians have attempted to remotely notify patients using an audiblebeeper. The audible beeper, however, is not very useful in remindingpatients which drugs to take, the proper dosage of those drugs, andwhether or not food must be taken with the drug. Moreover, the patientusually has no method to remotely respond to the physician. Thus, thephysician has no way of knowing whether or not the patient has compliedwith the drug regimen.

[0007] Various systems have been proposed to address the problem ofpatient medication compliance but such systems fail to provide acomplete or practical solution to the problem. For example, U.S. Pat.No. 4,473,884 to Behl, issued Sep. 25, 1984, describes a programmablemedication system for storing and dispensing pills. The system includesa dispensing unit with numerous compartments for storing pills. Eachcompartment is associated with an indicator. The unit further includes amemory for storing a medication regimen. At the appropriate time, anaudible alarm and the visual indicator remind the patient that aparticular drug must be taken. The Behl device has several drawbacks,however. First, the system, itself, is very complicated, requiring thepatient (or physician or pharmacist) to program in the regimen using amulti-key, multi-light control panel. Second, the device cannot beremotely programmed. Once the device leaves the control of the physicianor pharmacist, only the patient can physically alter the regimen. Third,the device places no limit on the individual number of pills that apatient may take. Thus, compliance is still not assured. Finally, thedispensing unit dispenses a fixed number of different medications. Ifthe patient requires more than four different types of medication, shemust remember to administer this medication manually.

[0008] U.S. Pat. No. 5,583,831 to Churchill, issued Dec. 10, 1996discloses a memory assistance device that reminds a patient to take aparticular medication. The device includes three separate units: areminder unit, a compliance processor, and a supervisory unit. Thereminder unit includes a microprocessor, a memory, an input key, and analarm to remind to audibly remind the patient to administer themedication. The compliance processor includes a CPU, a pill case, and amodem. Data on user compliance or noncompliance is stored in thecompliance processor and sent to the supervisory unit via modem. TheChurchill device, however, includes only a single pill case. Thus, thepatient cannot be reminded to take several different medications. Inaddition, the Churchill apparatus provides only limited response by thepatient to the physician. The patient cannot notify the physician ofcontraindications and/or side effects. Further, the Churchill device isstationary, thereby restricting the patient to his/her home or ward.

[0009] Accordingly, a need presently exists for a solution to themedication compliance problem. In particular, a need exists for a remotemedication dispensing system that stores a complex drug regimen andreminds patients to comply with medication requirements.

[0010] Further, a need exists for a medication dispensing system thatmonitors medication compliance.

[0011] Further, a need exists for a medication dispensing system thatallows patients to notify or respond to physicians or pharmacists aboutcontraindications or side effects.

[0012] Further, a need exists for a medication dispensing system thatcan hold many different types of medication.

SUMMARY OF THE INVENTION

[0013] The present invention is directed to a medication dispensing andmonitoring system which addresses the medication compliance problems. Ina preferred embodiment, the system of the present invention includes atwo-way or acknowledge-back pager for communication between a patient, aphysician, a health care organization, a pharmacist, and/or a drugsupplier. The pager sits in a carriage and communicates with thecarriage via a series of electrical contacts or similar methods. Thecarriage is coupled to one or more medication units that dispense storedmedication. The medication units may be combined to create a dispensingassembly. Each medication unit includes a canister storing medicationand a base medication dispenser engaged with the canister. The pager andcarriage include circuitry for receiving a prescription. At theprescribed times, the pager alerts the patient that medication must betaken. The patient may place the pager on the carriage and manually movethe carriage to the appropriate medication unit under control of thepager. A motor disposed within the carriage causes the dispenser todispense medication from the canister into a dispensing cavity. Thepatient may then retrieve the dispensed medication from the cavity.

[0014] The present invention satisfies the need for a solution to themedication compliance problem. Specifically, the present invention usesthe pager memory to store complex drug regimens and prescriptions. Theseregimens may be downloaded to the pager from a physician and/or healthcare organization located in a remote location. The need for a systemallowing patient notification is also satisfied by the presentinvention. Patients may send a message back to the physician or healthcare organization confirming medication compliance. Similarly, the pagermay be programmed to reply to the physician when the patient fails tocomply with a particular prescription. Finally, the system does notlimit the number of different medications that may be taken by thepatient. Rather, the present invention allows the coupling of numerousmedication units. In addition, the canisters of varying sizes may beused to accommodate different forms of medication.

[0015] A more complete understanding of the medication dispensing andmonitoring system will be afforded to those skilled in the art, as wellas a realization of additional advantages and objects thereof, by aconsideration of the following detailed description of the preferredembodiment. Reference will be made to the appended sheets of drawingswhich will first be described briefly.

BRIEF DESCRIPTION OF THE DRAWINGS

[0016]FIG. 1A is a perspective view of the remote medication dispensingand monitoring system of the present invention.

[0017]FIG. 1B is an exploded view of the medication unit, carriage, andpager of FIG. 1A.

[0018]FIG. 2A is a front perspective view of the medication unit andcanister.

[0019]FIG. 2B is a side cut-away view of the medication unit.

[0020]FIG. 2C is a front cut-away view of the medication unit.

[0021]FIG. 2D is an enlarged side cut-away view of the medication unitin a pre-dispensing position.

[0022]FIG. 2E is an enlarged side cut-away view of the medication unitin a dispensing position.

[0023]FIG. 2F is an enlarged side cut-away view of the medication unitin a post-dispensing position.

[0024]FIG. 2G is an enlarged side cut-away view of the medication unitin an empty position.

[0025]FIG. 2H is an enlarged side cut-away view of the medication unitin a pre-dispensing position.

[0026]FIG. 2I is an enlarged side cut-away view of the medication unitin a dispensing position.

[0027]FIG. 2J is an enlarged side cut-away view of the medication unitin a post-dispensing position.

[0028]FIG. 2K is an enlarged side cut-away view of the medication unitin an empty position.

[0029]FIG. 3A is a view taken along the lines 3A-3A of FIG. 1A.

[0030]FIG. 3B is a view taken along the lines 3B-3B of FIG. 3A.

[0031]FIG. 4 is a block diagram of the carriage circuit.

[0032]FIG. 5 is a block diagram of the pager circuit.

[0033]FIG. 6A is a diagram of a medication unit message transmitted to acentral database.

[0034]FIG. 6A is a diagram of a prescription message transmitted to acentral database from a drug supplier.

[0035]FIG. 6C is a diagram of a medication unit message transmitted to apatient from a physician.

[0036]FIG. 6D is a diagram of a prescription message transmitted to apatient.

[0037]FIG. 6E is a diagram of a response or report message transmittedby a patient to a central database.

[0038]FIG. 7 is a flow chart illustrating the transmission ofprescriptions to patients.

[0039]FIG. 8 is a flow chart illustrating the flow of information from adatabase to patients.

[0040]FIG. 9 is a flow chart illustrating the flow of information from apatient to a database.

[0041]FIG. 10 is flow chart illustrating the operation of the pager,carriage, and medication unit.

[0042]FIG. 11 is a flow chart illustrating the receipt of a message bythe pager.

[0043]FIG. 12 is a flow chart illustrating the transmission of a messageby the pager.

[0044]FIG. 13 is a perspective view of the pager, the carriage, andmultiple medication units.

[0045]FIG. 14 is a front cut-away view of two medication units.

[0046]FIG. 15 is an exploded view of the carriage and a medication unit.

[0047]FIG. 16 is a view taken along the lines 16-16 of FIG. 15.

[0048]FIG. 17 is a front view of a medication unit.

[0049]FIG. 18 is a perspective view of a canister informationprogrammer.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

[0050] Reference will now be made in detail to the preferred embodimentsof the invention, examples of which are illustrated in the accompanyingdrawings. Whenever possible, the same reference numbers will be usedthroughout the drawings to refer to the same or like parts.

[0051] As illustrated in FIGS. 1A and 1B, a remote medication dispensingand monitoring system 20 of the present invention includes a pager 30for remote communication. The pager 30 is a portable communicationdevice designed to receive packet messages via radio-frequencytransmission through paging networks. The paging networks transmitmessages such that the messages may only be received by a target device.Each message transmission may be time-delayed to reduce the overall loadon the network. Messages may include alphanumeric characters and/orsymbols. In the present invention, alphanumeric messages may betransmitted to a patient to remind the patient to take a particularmedication. As discussed in greater detail below, in lieu oftransmission of a medication message, a schedule or prescription messagemay be transmitted and stored in a memory of the pager.

[0052] In one-way paging networks, pagers are receive-only devices and,therefore, cannot transmit a message to the sender acknowledging andresponding to receipt of a message. A portion of the radio spectrum hasbeen allocated for Narrowband Personal Communication Services (“PCS”).Pager providers are using part of the allocated spectrum to providetwo-way (or “acknowledge-back”) paging services. The presence of atransmitter in the pager allows the pager to positively acknowledge thereceipt of each message and transmit short messages from the pager tothe paging network. Such acknowledge-back pagers become a time-shiftedpacket-based RF data communicator. Current devices, such as the pagersold under the trade name SkyWriter from SkyTel Corp., permit thecomposition and transmission of a message by the pager. Users of suchdevices also may receive and transmit electronic mail via the Internet.

[0053] As shown in FIG. 1B, the pager 30 enables communication between apatient, a physician, a medical care organization, a drug supplier,and/or a pharmacist. The system 20 further includes a carriage 50 forholding the pager 30 and a medication unit 70 for dispensing medication.The pager 30 may be slidably engaged with the carriage 50 and, asdiscussed in greater detail below, communicates with the carriage via aseries of electrical contacts 61 a, 61 b. The carriage 50 includes rails69 a, 69 b that are slidably engaged with and move along grooves 73 a,73 b disposed longitudinally along the length of the medication unit 70.

[0054]FIG. 2A is a front perspective view of the medication unit 70 usedfor storing and dispensing medication 100, such as a tablet or pill, tothe patient. As shown, the medication unit 70 includes a canister 80slidably coupled to a base dispenser 90. The canister 80 is a holder orcontainer composed of cardboard or a thin transparent plastic or similarmaterial, with a rigid base 86. The canister housing holds a group ofstacked pills or tablets 100. Although the canister 80 illustrated inFIG. 2A is rectangular, the canister 80 may be also formed toaccommodate pills having different shapes. For instance, acylindrically-shaped canister may be used to hold round tablets. Theheight of the canister 80 is variable depending upon the number oftablets that it is designed to hold. An upper end 83 of the canister 80is closed, while a canister base 86 includes an opening 85 (see FIG. 1B)for accessing the medication 100. A removable plastic seal (not shown)may be used to seal the opening 85 for storage and humidity controlprior to engaging with the base 90. The opening 85 is preferably formedin the shape of the inside cavity of the canister 80 to fit themedication 100 held therein. The canister base 86 is formed so as toslidably engage an upper surface 97 of a recess 92 formed within thebase dispenser 90.

[0055] A silicon ID chip 88 may be embedded into the canister base 86,connected to at least two contacts 84 a, 84 b, at a fixed distance froma side surface of the canister. A medication identifier encoded into theID chip 88 specifies the medication stored by the canister 80. Any knownencoding scheme may be utilized. The chip 88 is electrically coupled toone or more chip contacts 84 a, 84 b. The chip 88 may be a DS2401 chipmanufactured by Dallas Semiconductors. This chip contains uniquefactory-lasered and tested 64-bit word information, does not require aseparate battery, and may be interrogated without power by a single portof a microprocessor via two line connections at rates of up to 16.3kilobits per second. The same communication methodology may be utilizedto communicate with an ID chip containing nonvolatile random accessmemory (“NVRAM”) (e.g., the DS1991 or DS1996 NVRAM components by DallasSemiconductors) or erasable programmable read-only memory (“EPROM”)(e.g., the DS1896 EPROM manufactured by Dallas Semiconductors). Asdiscussed in greater detail below, the chip enables pharmacists toencode a specific identifier and/or instructions prior to issuing themedication. Moreover, consumption of medication may be stored in theNVRAM to enable multiple users to dispense medication from the samemedication unit.

[0056] The medication unit 70, as described herein, may be loaded by thepatient/end-user or may be pre-loaded by the drug supplier/packagingfacility. If the user loads the medication unit 70, the filled canister80 is packed and provided to the patient. Either the patient or a healthcare worker, such as a pharmacist, may insert the canister 80 into thebase dispenser 90. Upon consumption of all of the medication within thecanister 80, the canister may be replaced by a new filled canister ormay be recycled.

[0057] If the unit is pre-loaded by the drug supplier, the supplierhermetically seals the unit in plastic wrap or similar material toisolate the unit from humidity and other moisture. Prior to pre-loading,the canister 80 is placed upside-down and filled to its total lengthwith pills or tablets. To maximize the amount of pills stored by themedication unit 70, the base dispenser 90 may also be filled withmedication. A thin separator (not shown) is then placed on the canisterbase 86 and the canister 80 is placed on the base dispenser 90. The thinseparator is removed and the loaded unit is packaged for shipment to thepatient. Upon consumption by the patient, the complete medication unit70 may be disposed or returned to the drug distributor/packagingfacility for recycling. In FIG. 2B, for example, four pills arepre-supplied to the base dispenser 90. As explained above, the drugdistributor will then completely fill the canister 80 and couple thecanister 80 to the base dispenser 90.

[0058] FIGS. 2B-2C show the medication unit 70 in greater detail. Thebase dispenser 90 includes a housing 91 composed, for example, of alightweight plastic material. The housing 91 includes an upper surface97 having a recess 92 formed therein. As discussed above, the recess 92accommodates the canister base 86. The base dispenser 90 furtherincludes a front surface 95 having a plurality of grooves 73 a, 73 bformed therein. Each groove 73 a, 73 b is a T-shaped depressionintegrally formed within the base dispenser 90. The grooves 73 a, 73 baccommodate the carriage rails 69 a, 69 b. A first side surface 103 (seeFIG. 2C) includes a circular drum recess 105 formed therein. The drumrecess 105 accommodates a rotating delivery drum actuator 124, asdiscussed below. An entrance 140 to a dispensing cavity 125 is formedbeneath the drum recess 105. To facilitate the coupling of multiplemedication units, the base dispenser may include upper and lower flanges111 a, 111 b extending from a second side surface 107. A couplingbracket 119 is rigidly coupled to the first side surface of thedispenser 90. The coupling bracket 119 includes upper and lower grooves113 a, 113 b for slidably engaging the flanges 111 a, 111 b from anadjacent unit. A plurality of grooves are formed within the couplingbracket 119 to extend the grooves 73 a, 73 b of the base dispenser 90.The coupling bracket may be designed to vertically engage an adjacentmedication unit. For example, the coupling bracket may include avertically extending dove tail groove. The base dispenser may include atongue or similar structure for coupling with the groove. Thus, lateralmovement of an attached medication unit may be prevented.

[0059]FIG. 2B is a side cut-away view of the medication unit 70. Asshown, the canister base 86 engages an upper surface 97 of the basedispenser recess 92. A lower surface 87 of the base dispenser recess 92further includes an angled notch 94 engaging the recess 84 in thecanister base 86, thus preventing the canister 80 from being easilyremoved. Once installed, the medication are fed from the canister 80 andstacked atop a delivery drum 120. The canister 80 may include anoptional spring 89 (see FIG. 14) disposed therein proximate the upperend 83 of the canister. The spring places an additional force on themedication 100 to push the column of pills or tablets down and, thereby,prevent sticking or clumping of tablets or pills. Medication isdispensed into a dispensing cavity 125. Specifically, a single pill ortablet is dispensed per each revolution of the delivery drum 120. Thedispensing cavity 125 is a hollow opening within the base dispenser 90located beneath the delivery drum 120. The dispensing cavity 125 islarge enough to permit the patient to manually retrieve the dispensedmedication 100 by tilting the medication unit 70 to one side.

[0060]FIG. 2C is a front cut-away view of the base dispenser 90. Asshown, the medication 100 is gravity-fed from the canister 80. Thebottom-most pill or tablet 100 sits within a delivery drum 120. Thedelivery drum 120 includes a delivery drum housing 122 and a deliverydrum actuator 124. The delivery drum housing 122 is a hollow rotatablecylinder with an opening for receiving a single piece of medication. Thedelivery drum housing 122 lies flush against an inner side surface 104of the base dispenser 90 or has short axles 123 a, 123 b within holes129 a, 129 b in the base 91 and the coupling bracket 119, respectively.The drum housing 122 is coupled to the circular delivery drum actuator124. The delivery drum actuator 124 is a circular member with asaw-tooth outer surface 127. The outer surface 127 includes a pluralityof serrations that may be manually or mechanically used to rotate theactuator 124 and, thereby, rotate the delivery drum 120.

[0061] FIGS. 2D-2G illustrate the dispensing of a particular shape ofmedication from the delivery drum 120. In the pre-dispensing position, asingle medication 101 is held in the delivery drum housing 122. When thedelivery drum actuator 124 (see FIG. 2C) is rotated, the delivery drumhousing rotates into the position shown in FIG. 2E. As the delivery drum120 continues to rotate, the medication 110 disposed atop the dispensingmedication 100 is moved into a pre-dispensing position. The dispensingmedication 100 located in the housing 122 is then gravity-fed into thedispensing cavity 125 disposed beneath the delivery drum 120 as shown inFIG. 2F. The next pill 110 is then gravity fed into the delivery drumhousing 122 for dispensing.

[0062] FIGS. 2H-2K illustrate the dispensing of a round pill with asquare-shaped cross-section. As shown, the shape of the delivery drum220 may be altered to accommodate the various shapes and sizes ofmedication. The single medication 200 now rests along inner surfaces213, 217 of the delivery drum 220. The mechanics of the delivery drum220, however, remain the same. Thus, rotation of the delivery drumactuator (not shown) causes a corresponding rotation of the deliverydrum 220. As the delivery drum 220 turns, the medication 200 falls intothe dispensing cavity 125 for receipt by the patient.

[0063]FIG. 3A is a side cut-away view of the carriage 50 coupled to themedication unit 70. The carriage 50 communicates with the two-way pager30 and causes the mechanical rotation of the medication unit's deliverydrum actuator 124. An upper surface 57 of the carriage 50 is angleddownwardly to accommodate the pager 30. Lower flange 54 is curved toretain the pager 30. The pager 30 slides between a lower carriage flange54 and rests upon the upper surface 57. A series of electrical contacts61 b (see FIG. 1B) are aligned along a side of the upper surface 57 ofthe carriage. The pager 30, as discussed below, contains a correspondinggroup of electrical contacts 61 a for communication between the pager 30and the carriage 50. Alternatively, the carriage 50 may include aninfra-red transceiver, while the pager 50 may include an infra-redtransceiver. If infra-red communication is used, the pager 30 need notbe retained by the carriage 50.

[0064] The carriage 50 houses a battery 140, a motor assembly includingelectric motor 55 coupled to a first rotatable worm gear 64 by a firstshaft 61. The electric motor is driven by the circuit shown in FIG. 4.The first worm gear 64 engages a second worm gear 68 having a directionof rotation at 90° from that of the first worm gear 64. The second wormgear 68 is coupled to a second shaft 67. The second shaft 67 passesbetween circular shaft retainers 63, 65 coupled to rear inner surface 57of the carriage 50. The second shaft 67 is coupled to a rotatablecarriage gear 77. A rectangular opening along the rear surface of thecarriage 50 allows the carriage gear 77 to engage the drum actuator 124when the carriage 50 engages the base medication dispenser 90. The fixeddistance from all medication unit contacts 84 a, 84 b guarantees thatwhen contact is made between carriage contacts 74 a, 74 b and medicationunit contacts 84 a, 84 b, the carriage gear 77 will engage drum actuator124. The spring 66 pushes the rotatable carriage gear 77 outward towardsthe medication unit 70 and provides flexibility to engage the serrations127 of the dispensing drum actuator 124.

[0065] The carriage 50 includes two rails 69 a, 69 b disposed along alength of the rear surface of the carriage 50. The rails 69 a, 69 bslidably engage the grooves 73 a, 73 b, along the front surface of themedication unit 70. Once the carriage rails 69 a, 69 b engage thegrooves 73 a, 73 b, the medication unit 70 may be adjusted such that thegrooves of the carriage gear 77 contact the serrations 127 of thedelivery drum actuator 124. Thus, the motor 55 indirectly causesrotation of the delivery drum actuator 124. Special notches may beformed on the rails 69 a, 69 b along with corresponding depressions inthe grooves 73 a, 73 b of the medication unit 70 to provide an audibleindication to the user that the medication unit and carriage areengaged. In addition, the notches and depressions serve to secure therelative position of the carriage 50 onto the medication unit 70.

[0066]FIG. 4 is a block diagram of the carriage circuit which powers thecarriage motor 55. A power source, such as a battery 140, provideselectrical power to a motor driver 147 and a dispenser control 149. Thecontrol may be an on/off switch 21 disposed on a front surface of thecarriage (see FIG. 1A) creating an electrical path between the battery140 and the other components in the circuit. The dispenser control 149is a firmware controller that controls the dispensing operation of thecarriage 50. In addition to firmware, the controller 149 may also beinstructed by a read-only memory (“ROM”) 148 containing code forcommunicating with the ID chip 88, LED indicator 22, the motor drive,and for controlling the dispensing operation.

[0067] The controller directs operation of a motor driver 147 and anindicator 22 disposed along the front surface of the carriage proximatethe on/off switch 21. The indicator may be a light-emitting diode(“LED”) that, for example, alternates between green and red states,where red indicates that power is being supplied to the controller 149and green indicates a ready-to-dispense state. Other indicators are alsopossible. When the dispenser control 149 provides a control signal tothe motor driver 147, the driver 147 initiates and ceases rotation ofthe motor 55. Rotation of the motor 55 indirectly rotates the deliverydrum actuator 124 to dispense medication 100 from the canister 80 intothe dispensing cavity 140.

[0068] The controller 149 communicates with the pager 30 via electricalbus contacts 61. Alternatively, the controller 149 and the pager 30 maycommunicate using infra-red or radio-frequency technology. A canistercontact 136 allows the controller 149 to read the ID chip 88 embedded inthe base 86 of the canister 80. As stated above, the ID chip 88indicates the medication stored in the canister 80. The canister contact136 may be a gold-coated spring leaf contact that electrically coupleswith the chip contacts 84 a, 84 b. The controller 149 may then decodethe silicon chip 88 to determine the medication stored in the canister80.

[0069] The information encoded into the canister ID chip 88 providespositive identification and confirmation of the proper medication. Thecontacts 74, 84 provide localization information prior to activation ofthe dispensing motor, thus ensuring that the canister is positionedcorrectly to engage the actuator 124. It should be apparent, however,that other means may be used to ensure such contact. For example, amagnetic strip on the canister 80 and a magnetic reader on the carriage50 may be utilized. Similarly, a bar code disposed on the canister 80and an optical reader on the carriage 50 may be used to storeinformation about the specific medication and provide localizationinformation.

[0070]FIG. 5 is a block diagram of the circuitry for theacknowledge-back pager 30. Acknowledge-back paging circuits arewell-known and described in U.S. Pat. No. 5,563,382, to Nikas, issuedOct. 31, 1995, which is incorporated by reference herein. The pager 30is a portable acknowledge-back pager, such as the pager sold under thetrademark Tango by Motorola Corp., although other acknowledge-backpagers may be used. The pager 30 includes an antenna 120 for acceptingmessages transmitted from a remote message transmitter as radio signals.The antenna 120 is coupled to an antenna switch 121 for steering thesignals to and from the antenna. The antenna switch 128 is controlled bya processor 130. The switch is further coupled to a message receiver 129for demodulating the radio signals sent from the antenna switch 128. Themessage receiver 129 is coupled to a decoder 136 and the processor 130for decoding and processing information carried in the radio signals.The processor 130 is coupled to a memory 139, such as a random accessmemory (“RAM”), for storing messages in memory locations. The RAM 139stores a plurality of messages, including standard paging messages 164medication messages 168 a and prescription messages 171 a. As discussedin greater detail below, each medication message contains a serial IDnumber for a canister containing a prescribed drug and a pointer orreference to a unique prescription message for that medication. Thecanister ID number stored in RAM corresponds to the encoded data in thecanister ID chip 88 embedded in the lower surface of the canister 80.The prescription message, as described in greater detail below, containsspecific medication dispensing information, such as a timing regimen(e.g., three times a day), indications, contraindications, and otherinformation or instructions associated with the medication. Theprocessor 130 is also coupled to an output element 33, such as a displayfor alphanumeric messages and/or a loudspeaker for synthesizing voiceoutput.

[0071] The processor 130 is further coupled to a control section 138,comprising well-known switches and buttons, such as a touch pad andnavigation buttons disposed adjacent the display. The touch pad includesfour pads surrounding a central touch key. The four pads and the centraltouch key allow the user to select alphanumeric entries listed in thedisplay. For instance, each pad may correspond to the desired direction(up, down, left, and right) of a cursor within the display. Once anentry has been highlighted or otherwise indicated, the central touch keymay be used to select that entry. It should be apparent, however, thatanother user interface may be employed. For instance, an alphanumerickeypad may be used to enter text directly into the display. Theprocessor is coupled to an alert element 157, such as a conventionalpiezoelectric transducer (“PZT”) for generating an audible or visiblealert in response to receiving information intended for the pager 30. Anindicator 155, such as an LED or liquid crystal display (“LCD”), is alsocoupled to the processor 130 for providing a visible indication to theuser that there is a message on the pager display. It will beappreciated that the indicator 155 can be integrated with either theoutput element 33 or the alert element 157, or both, as well.

[0072] The processor 130 is also coupled to an acknowledge transmitter160 for controlling the generation of acknowledge messages therefrom.The acknowledge transmitter 160 is coupled to the antenna switch 128 forsteering the acknowledge messages to the antenna 120 for transmission toa paging service or other infrastructure. The processor 130 is coupledto a read-only memory (“ROM”) 159 comprising firmware elements includinga selective call address 162 for uniquely identifying the pager 30. Thefirmware elements preferably also include two-way pager operation code167 which controls pager operation and dispensing operations programcode 163. The code for pager information controls several pagerfunctions, including medication message processing in RAM memory,monitoring the next action and displaying information for the patient,dispensing control, and enabling read and/or write into the ID chip 88.These operations can be implemented using a standard one-way pager. Thecode that composes the compliance messages for pre-scheduledtransmission is applicable to a two-way pager. Message reception andconfirmation are handled routinely by a two-way pager with the additionof multiple choice answer selection for reply to alphanumeric messagesand storage of pre-prepared queries.

[0073] The pager circuit further includes a dispenser interface 170 forcommunication between the pager and the carriage. The interface 170 maybe electrical contacts 61 b (see FIG. 1B) electrically coupled to thecarriage contacts 61 a. Alternatively, the interface 170 may be an RS232interface, an infra-red link, or a radio-frequency link. The interface170 is coupled to the processor 130.

[0074] The two-way pager 30 is part of a communication infrastructurethat permits two-way communication among physicians, pharmacists, healthcare organizations, paging services, and subscribers (patients).Depending upon the type of paging service, the message received from thepaging service may be either a numeric message, an alphanumeric message,or a voice message. A message is sent to a subscriber via the pagingservice access number (usually a toll-free telephone number).Alternatively, a message may be sent via another communication networkthat couples into the RF paging network(s), such as the Internet. Thepaging service then transmits the message throughout the service areausing base stations which broadcast the paging message on a radiocarrier. The subscriber may respond to the message using the touch pad35.

[0075] FIGS. 6-12 illustrate the global flow of messages in a networkcontaining at least one patient using the medication dispenser of thepresent invention, at least one database storing patient medicationinformation, and at least physician or pharmacist. Preferably, thedatabase is a computer system administered by a health care company orthe physician or pharmacist, or a vendor of the dispenser. Messages maybe sent back and forth through this network using a standard two-waypaging network. Messages may also be sent and received using atelephone, cable, or wireless network. In addition, internet or intranetmessaging networks are possible for messages sent by paging networksconnected to the internet.

[0076] As described herein, the database is a depository of patientmedication data, prescription, supplied medication units, and complianceinformation. The database may reside in the physician computer, within ahealth care organization, within a medication unit manufacturer, orwithin a drug distribution organization. Numerous databases may existand communicate with different clients. Only one central database,however, is necessary to identify a patient relative to a particularinternal database. This central database may be placed within the pagingnetwork computers that act as a traffic coordinator for all messages.

[0077] FIGS. 6A-6E show exemplary message structures for messagestransmitted within the network. A “New Medication Unit->DB” message 168b is transmitted by a physician or pharmacist to the database to informthe database that a new medication unit has been provided to thepatient. For example, the physician may provide the patient with anoffice sample of a medication unit. To inform the database of thisprovision and, thereby, “activate” the medication unit, the physicianmust transmit the “New Medication Unit->DB” message 168 b. The databasewill then forward the message to the patient and the serial ID andmedication ID will be stored in RAM 139 of the pager 30 as medication168 a. The message 168 b includes a serial ID number 165 indicating thespecific canister given to the patient. A medication ID number 169 isused to specify the medication contained in the medication unit. Eachpatient is assigned a unique patient ID number 172 that is included inthe message 165 that is sent by a prescribing physician/pharmacist. Allmessages conclude with an end-of-message signal 173 that may include anerror detection code. The error code is designed to ensure the integrityof a message, including all of the required message components.

[0078] When the physician provides the patient with a new prescription,the physician transmits a “New Prescription->DB” message 171 b to thedatabase. The database will forward the message 171 b to the patient andthe information, excluding the patient ID and END components, will bestored in the RAM 139 of the pager 30 as a prescription 171 a. The “NewPrescription>DB” message is illustrated in FIG. 6B. The message includesthe patient ID number 177, a physician ID number 179 that uniquelyspecifies the prescribing physician, and the medication ID number 181.The message 171 further includes a dosage/timing component 183 and theterm 185 of the prescription. Special instructions 187 may follow theterm 185 component. An optional interaction component 191 may specifycontraindications and foods that may not be taken with the medication.The message concludes with an end-of-message signal 193 that may includean error detection code.

[0079] To activate a new medication unit and permit dispensing by thedispenser, the database system transmits a “New Medication Unit->P”message 168 c to the patient after receiving the “New MedicationUnit->DB” message 168 a from the pharmacist/physician. The “NewMedication Unit—>P” message 168 c is illustrated in FIG. 6C. The “NewMedication Unit- >P” message 168 c includes the serial ID number 203 andmedication ID number 205. The database specifies a new prescription bytransmitting a “New Prescription->P” message 171 c containing themedication ID number 213, the dosage/timing component 215, the term 217,the optional special instructions 219, and optional contraindications221. The database uses the patient ID 172, 177 to create a messagespecific to the patient. The messages 178 c, 171 c are similar tomessages 168 b, 171 b, excluding the patient ID. Thus, only the targetpatient will receive the message.

[0080] The patient may also send messages to the physician through thedatabase. A patient message, “Patient->DB” 231, begins with a messageclass identifier 233. The message class indicates the type of messagebeing transmitted by the patient. Certain pre-defined message classesmay exist. For instance, sample message classes include a daily reportclass automatically downloaded from the patient during low-networktraffic time (e.g., overnight), a patient-initiated emergency class, apatient-initiated query class, an unrecognized medication unit class,and a regular two-way message class for regular pager operation. Themessage class is followed by a statement 235 component from the patient.The statement 235 may be an alphanumeric message generated by thepatient or chosen from a menu of predefined messages. The message 231further includes the dispensing information 237 provided by the patient.The dispensing information indicates the medication ID, the dosagetaken, and the time the dosage was administered. Dispensing informationfor each medication (in the case of multiple medication units) may beincluded.

[0081]FIG. 7 is a flow chart illustrating the global flow ofprescription data from a prescribing physician or pharmacist to adatabase. In step 501, the physician may prescribe medication in atleast two ways. She may prepare a conventional paper slip prescriptionin step 503 or she may use an automated in-office method for preparingprescriptions in step 505. If a paper to prescription is prepared, thepatient must locate an accessible “wired” pharmacy in step 507. A wiredpharmacy is a pharmacy with access to the network containing patient andmedication information. The wired pharmacy is also capable of dispensinga medication unit to the patient. The patient may optionally phone thepharmacy with the prescription in step 509. In step 513, the patientvisits the wired pharmacy to fill the prescription. The pharmacist, instep 517, sends the “New Prescription->DB” message 171 b to thedatabase. This prescription is confirmed by the database and forwardedto the patient as a “New Prescription->P” message 171 c, as describedbelow. The pharmacist fills the prescription by providing a medicationunit to the patient in step 521. The pharmacist may demonstrate the unitif necessary. The pharmacist, in step 525, then sends a “New MedicationUnit->DB” message 168 b to the database to indicate that the medicationunit has been provided. The database, as discussed in greater detailbelow, confirms the information contained in the message and forwards a“New Medication Unit->P” message 168 c. The database, in step 529,transmits the appropriate message to the patient's pager. The patientmay then operate the dispenser and receive medication from themedication unit.

[0082] Alternatively, the physician may use an automated in-officesystem for processing prescriptions. In step 533, the physician reviewsthe patient's current prescriptions and decides on an acceptablemedication regimen. Next, in step 537, the physician transmits the “NewPrescription- >DB” message 171 b to the database. The downloadedprescription is stored in the database and forwarded to the patient as a“New Prescription->P” message 171 c. The physician provides the patientwith an instruction sheet describing the operation of the dispensingsystem. In step 545, the patient decides whether or not to use a wiredpharmacy or mail in the order. If the pharmacy is chosen in step 549,the physician provides the patient with a list of wired pharmacies inthe area. The patient may then proceed to step 507 and locate a wiredpharmacy. If the patient decides to mail in the order, he may receivesample medication units from the physician in step 553. In step 559, thepatient may choose between manual delivery of the sample medication orautomated dispensing of the sample medication. If manual delivery ischosen, the physician, in step 561, may provide the patient with loosepills or tablets. The patient may use these pills until his medicationunit arrives by mail. In step 565, the patient awaits receipt of amedication unit by mail. If automated dispensing of sample pills ischosen, the physician may provide a sample medication unit to thepatient for demonstrative purposes in step 569. The physician then sendsthe “New Medication Unit->DB” message 168 b to the central database. Thedatabase will forward the message to the patient as a “New MedicationUnit->P” message 168 c. A mail fulfillment center for the medicationlogs the medication unit transmitted to the patient, similar to the stepperformed by the pharmacist in step 525.

[0083]FIG. 8 is a flow chart illustrating the flow of data from adatabase to a pager 30, upon receipt of a “New Medication Unit->DB”message 168 b or a “New Prescription->DB” message 171 b from thephysician/pharmacist or drug supplier. As stated above, the physicianmay transmit a “New Medication Unit->DB” message 168 b to specify that anew medication unit has been provided, and a “New Prescription->DB”message 171 b to indicate that a new prescription has been given to thepatient. Upon receiving the “New Medication Unit->DB” message from theprovider in step 601, the database, in step 605, verifies orauthenticates the source of the message. In steps 609-613, the databaseverifies that the patient ID and the medication ID are stored in thesystem. If either of the message components cannot be verified, thedatabase, in step 621, issues a “problem response” message. In step 625,the database waits for a response correcting or clarifying thetransmitted message. In step 629, the system determines whether or notthe data has been resent. If the data has been resent, the databasereturns to step 605. If the data has not been resent, the databaseissues a “Restart” message to the physician/pharmacist and deletes thecurrent transaction in step 633.

[0084] If the patient ID and medication ID are verified by the system,the database issues the proper messages, “New Prescription->P” message171 c or a “New Medication Unit” message 168 c in step 641. In step 645,the database awaits a confirmation from the patient indicating that themessage has been received. If no confirmation is received, the database,in step 649, determines whether the message may be re-transmitted. Afixed number of re-transmission tries may be specified by the databaseadministrator. If re-transmission exceeds the number allowed, thedatabase notifies the administrator in step 651. If re-transmission ofthe message is permitted, the system returns to step 641. When thepatient confirms receipt of the message, the confirmation is transmittedto the database in step 655. In step 659, the database updates thepatient's medical record.

[0085] Upon receiving a “New Prescription->DB” message 171 b in step663, the database verifies or authenticates the source in step 667. Insteps 671-685, the database verifies the patient ID, physician ID,medication ID, dosage/timing/term parameters, and interactionevaluation. If any of these message components cannot be verified, thedatabase issues, in step 687, issues a “problem response” message. Instep 689, the database waits for a response correcting or clarifying thetransmitted message. In step 691, the system determines whether or notthe data has been resent. If the data has been resent, the databasereturns to step 667. If the data has not been resent, the databaseissues a “Restart” message to the physician and deletes the currenttransaction in step 695. Once each message component has been confirmed,the database continues in step 641 by issuing the proper message, “NewPrescription->P” message 171 c in this case.

[0086]FIG. 9 illustrates the flow of data from the patient back to thedatabase. Upon receipt of the “Patient->DB” message in step 701, thedatabase verifies or authenticates the source. In step 709, the databaseperforms an error check to verify the integrity of the message. If noerror is found, the database then tries to match the patient ID with astored ID in step 713. If an error is found or if the patient cannot beverified, the database issues a “Retransmit” message back to the patientin step 717. The database then determines whether the number ofretransmission attempts has exceed the allowable limit under the systemadministrator's rules. In step 721, the database waits for the nextmessage. If re-transmission is not permitted, the database informs thesystem administrator of the problem in step 725. Once the patient ID hasbeen verified, however, the database then attempts to resolve themessage class component of the message in step 729.

[0087] When the message is a daily report message, the database verifiesthe medication IDs in step 737. If the medication IDs or one of themedication IDs cannot be verified, the database goes to step 717 andissues a “Retransmit” message. Once the medication ID is verified, thedosage/time component of the message is resolved in step 741. In step745, the patient's medical record is updated. In step 749, the databasethen determines whether or not the patient has properly complied withthe medical regimen stored in the patient's record. The database alertsthe patient if he fails to comply with the regimen. In step 755, thedatabase alerts others, such as the physician or other medicalpersonnel. The database system, in step 771, determines whether themessage has been processed completely. If the message has not beenprocessed completely, the system re-initiates the response and deletesthe current transaction in step 775. If the message has been processedcompletely, the database updates the patient's record in step 779 andsends a confirmation back to the patient in step 783.

[0088] When the received message is not a daily report, the systemattempts to resolve the target of the incoming message. In step 791, thedatabase informs the appropriate target. FIG. 9 lists sample targets,including a physician 795, a medication supplier 796, a health careprovider 797, a family member 798, and an expert system processor 799.It should be understood, however, that other persons or organizationsmay be included. Once the message has been passed on, the databaseproceeds to step 771.

[0089] FIGS. 10-12 illustrate the operation of the device and the localprocessing of messages. As discussed above, paging and dispensingoperations 163 may be stored in the pager ROM 159 or by the controller149 of the carriage 50. FIG. 10 illustrates the pager-dispenseroperation. At start-up, operation of the pager 30 begins with a startsignal in step 801. At this step, temporary memory buffers are clearedand registers are re-set. At step 805, the processor scans the list ofprescriptions 171 a stored in pager RAM 139. The processor, in step 809,decides whether or not medication is due based on the accessedprescription list. If no medication is due at this time, the processorsearches for instructions regarding pre/post medication consumption(e.g., a warning not to eat within two hours prior to taking aparticular medication). If none exist, the processor displays the normaltime and date in step 809 and operates the pager as a normal two-waypager. If instructions are available, the instructions are displayed instep 813, indicator 155 may be activated, and the pager functions as atwo-way pager.

[0090] When medication must be administered, the patient is alerted instep 819 via an audible beep through loudspeaker 157 and the display ofan alphanumeric message. The patient must respond to the device toconfirm receipt of the alert message. When no response is received, thepager waits a predetermined amount of time (e.g., 45 minutes) beforetransmitting an alert message to the database in step 823. Once thepatient responds, the processor attempts to establish communication withthe carriage in step 831. If no communication can be established withthe carriage, the pager enters a snooze mode for a predetermined amountof time in step 833. If communication is established, the pager 30determines whether or not it is placed on the carriage 50. If the pager30 has not been placed on the carriage 50, the pager 30 enters a snoozemode at step 833, waits a fixed amount of time, and checks again in step829. Once the pager 30 recognizes that it is sitting on the carriage 50,the processor then interrogates the medication unit by reading theserial ID number of the medication unit in step 841. In step 845, theprocessor compares the medication unit ID number with the medication IDnumber specified in the current prescription. If the two numbers do notmatch, the processor, in step 849, compares the medication unit IDnumber with a stored local list of medication ID numbers. The processorissues an “Unrecognized Medication Unit” message when the ID numbers donot match in step 851. If the medication is among the approvedmedications on the list, the processor displays the message “Move toNext Medication Unit” (in the case of multiple medication units) andreturns to step 801.

[0091] When the medication unit ID number and the current prescribedmedication ID number match, the pager alerts the patient through anaudible beep and an alphanumeric message in step 863. The processor, instep 867, determines the current dispensing state of the medicationunit. If no dispense command or control signal has been issued, theprocessor waits a predetermined amount of time before transmitting analert message back to the database in step 875. Once the dispensecommand or control signal has been issued, the carriage motor moves onefull turn to dispense the medication from the delivery drum into thedispensing cavity in step 883. Optionally, after dispensing, theprocessor, in step 887, may verify that the next pill or tablet isloaded in the delivery drum for the next pill cycle. This method isdescribed in greater detail below. Once the pill has been loaded andconfirmed, processing resumes at step 801. If the pill fails to load,the user is alerted through an audible beep and an alphanumeric messagein step 891. Once the patient manually loads the pill or resolves theproblem by shaking the unit, processing resumes at step 801. Where thedelivery drum problem cannot be fixed, the pager transmits an “Out ofInventory” message to the database in step 899, and returns to step 801.

[0092]FIG. 11 is a flowchart illustrating the receipt of a message bythe pager 30. In step 903, the pager processor receives an incomingmessage. If the message is a standard pager message, the pager functionsas a two-way pager in step 911. If the message is not a pager message,the processor performs an error check on the message. Should the messagefail the error check, the processor issues a “Retransmit” request to thesender. Once the message has passed the error check, the processorattempts to resolve the message type in step 921. For “New Prescription”messages 171 b, the processor updates the list of prescriptions 171 astored in RAM 139 by adding a new prescription 171 a in step 935. A “NewMedication Unit” message 168 b is processed by updating the list ofmedications 168 a to include the new medication unit in step 939.“Alert” messages are processed by displaying the message and producingan audible beep. Once the message has been processed, an internal checkis made in step 951. If the internal check fails, the pager requests there-transmission of the message in step 959. If the internal checkpasses, the pager transmits a confirmation back to the sender in step955.

[0093]FIG. 12 is a flowchart illustrating the transmission of a messageby the pager 30. Patient-initiated messages 1021 are treated likestandard two-way messages. For daily report preparation, a daily reportmessage is held until a daily report becomes due. In step 1057, the“Patient->DB” message containing the daily report is prepared. Theprocessor adds an error detection code in step 1061 and then transmitsthe message in step 1065. The processor waits a predetermined amount oftime in step 1091 before expecting confirmation of the message in step1093. If no confirmation is received, the message is re-transmitted.Once confirmation has been received, the message is resolved. If theconfirmation is a daily log message, the log stored in RAM is deleted instep 1099. Otherwise, the message is marked as sent in step 1097.

[0094] When the carriage fails to recognize a medication unit, themessage is routed to the database. The patient ID and canister ID aretransmitted in step 1089. When the canister runs out of medication, a“Patient->DB” message is routed to the supplier or physician in step1081.

[0095] Finally, the processor transmits a message when the patient failsto respond to an “Alert” message. After waiting for a predeterminedperiod in step 1049, a “Patient Does Not Respond” message is preparedand routed to the physician or health care provider in step 1073.

[0096]FIG. 13 illustrates a second embodiment of the medicationdispensing and monitoring system of the present invention. In thisembodiment, several medication units are linked together to form amedication unit assembly 1000. The assembly provides a unified solidstorage and a portable system that the patient may easily transport in apurse or briefcase. The linking of medication units facilitates thedispensing of several types of medication. For instance, FIG. 13 showscanisters 70 of differing heights and shapes to accommodate variousforms of medication. Moreover, patient compliance with more than onemedication may be monitored.

[0097]FIG. 14 is a cut-away view illustrating the coupling of twomedication units. As shown, each canister accommodates a different pill.Each unit, however, includes the coupling bracket 119 for coupling amedication unit to an adjacent unit. The coupling bracket 119 includesgrooves 113, 114 that slidably engage the flanges 111, 112 disposedalong the side surface 107 a of the base dispenser 90 a. A collection ofmedication units form a medication unit assembly 1000. Dispensingsimilarly in each dispenser 90. Specifically, medication 100 a isgravity-fed into a delivery drum 120 a while medication 100 b is fed viaspring pressure to the delivery drum 120 b. Rotation of the deliverydrum actuator causes the delivery drum 120 a to rotate and deliver themedication into the dispensing cavity (not shown). As the dispensingdrum continues to rotate, an adjacent pill falls into the dispensingdrum for dispensing.

[0098] Medication unit assembly 1000 couples to the carriage 50 as shownin FIG. 15. Specifically, the grooves 73 a, 73 b of the medication unitsare combined together to form continuous grooves for the carriage rails69 a, 69 b. The patient may manually engage the carriage 50 with themedication unit assembly 1000. The patient may then move the carriage 50to the correct medication unit where the local ID is determined, asexplained above. Alternatively, the assembly 1000 may be placed on atable and the carriage may then be fit into the medication assembly1000. For support during lateral motion of the carriage 50 from onemedication unit to the next, the carriage 50 may contain a small wheel53 (see FIGS. 3A, 3B) that supports the weight of the carriage whenplaced on a flat surface. It should be apparent that the lateralmovement of the carriage may be mechanized to move automatically fromone medication to the next without patient intervention. Specifically,the carriage controller may be programmed to move the carriage 50 via anadditional motor.

[0099] The base dispenser 90 may further be provided with two lightpipes 106 a, 106 b for determining whether medication is presentlystored in the delivery drum 120. FIGS. 16 and 17 show the light pipes106 a, 106 b in greater detail. The light pipes 106 a, 106 b are acryliclight pipes angled to provide a continuous path of light from a firstentry point 116 at a fixed distance to a second entry point 118proximate the delivery drum actuator 124. The distance from the firstentry point 116 to the second entry point 118 is the same for eachmedication unit, regardless of the size of the medication unit. Thecarriage 70 includes a first light source 72 a, e.g., LED, and a firstdetector 72 b along a rear surface thereof to detect light from-thefirst entry point 116 transmitted to the second entry point 118,respectively. When medication 100 is located within the delivery drum120, the light path between the light pipes 106 a, 106 b is disrupted.When the delivery drum 120 is empty, however, the light passes from thefirst entry point 116 to the second entry point 118. This light presenceis detected by the carriage detectors 72 b. The detector 72 b may beelectrically coupled to the carriage controller 149 for use indispensing operations, as described above. The light pipes 106 a, 106 bact as center axes about which the delivery drum 120 rotates.

[0100] In addition, a mechanism for detecting the completion of a fullrotation of the medication delivery drum 120 may be provided. A smallreflector 129 (see FIG. 3A) may be attached proximate the rim of thedelivery drum actuator 124 to provide a line of sight to the reflector129 from a second light source 72 c and a second detector 72 d (see FIG.15). The reflector 129 may be composed, for example, of 2 mm round,reflective thin aluminum foil. The reflector 129 provides a strongsignal to the detector 72 d only when the delivery drum 120 is in oneparticular rotational position. FIG. 16 illustrates the relativeposition of the second light source 72 c and the second detector 72 d.The detector 72 may be electrically coupled to the carriage controller149. During rotation of the delivery drum 120, the source 72 c anddetector 72 d are activated. The controller may provide a drive commandto the motor until the reflector 129 returns to the line of sight of thedetector 72 d.

[0101]FIG. 18 illustrates a canister programmer enabling the pharmacistor drug supplier to encode specific information (e.g., expiration date,manufacturing lot number, amount loaded). using an NVRAM or EPRONversion of the ID chip 88 as described above. The encoded informationmay be read by the carriage controller or the pager and may be used inthe dispensing procedure for the patient. The canister 80 slidablyengages into a mating adaptor 1800. Contacts 84 a, 84 b are electricallycoupled to contacts 1874 a, 1874 b in the adaptor 1800. A cable 1803connects the adaptor 1800 to an interface box 1805 containing amicrocontroller that communicates with the programmable ID chip 88. Themicrocontroller 1805 may be used to read or write information to thechip 88. The interface box 1805 is connected via a cable 1810 to acomputer 1820 that provides a simple user interface for inputting thedata. The adaptor 1800 may be connected directly to a port on thecomputer 1820. The adaptor 1800 further includes an opening 1850 thatmay be used in connection with an automatic filling station for thecanister 80. When the adaptor 1800 is coupled to an automatic fillingstation, medication may be provided to the canister 80 through theopening 1850.

[0102] Using the programmable version of the ID chip 88, consumption ofmedication may be subtracted from an initial value such that thecanister will contain updated quantity information about its medicationcontent. The carriage controller or the pager reads the quantity storedprior to dispensing. Following dispensing, the controller or pagerwrites back the correct amount. This method may be used when the patientdesires to tracking compliance of over-the-counter medication.

[0103] Having thus described a preferred embodiment of a remotemedication dispensing and monitoring system, it should be apparent tothose skilled in the art that certain advantages of the within systemhave been achieved. It should also be appreciated that variousmodifications, adaptations, and alternative embodiments thereof may bemade within the scope and spirit of the present invention. For example,manual lateral carriage operation has been illustrated, but it should beapparent that the inventive concepts described above would be equallyapplicable to mechanical transport of the carriage 50 between differentmedication units. In addition, the 10 delivery drum 120 may be rotatedseveral times for prescriptions requiring greater than one pill. Theinvention is further defined by the following claims.

What is claimed is:
 1. A medication dispensing system comprising: apager; and a medication unit, including an apparatus for dispensingstored medication, and communicatively coupled to the pager.
 2. Themedication dispensing system, as recited in claim 1 , wherein themedication unit is mechanically but removably coupled to the pager. 3.The medication dispensing system, as recited in claim 1 , wherein themedication unit is infra-red coupled to the pager.
 4. The medicationdispensing system, as recited in claim 1 , wherein the pager is anacknowledge-back pager.
 5. The medication dispensing system, as recitedin claim 1 , further comprising: a coupling bracket rigidly coupled to asurface of the medication unit; and a second medication unit removablyengaged with the coupling bracket.
 6. The medication dispensing system,as recited in claim 1 , wherein the pager includes a paging circuitcomprising: means for receiving a packet message; a processor coupled tothe receiving means; a random access memory coupled to the processor; aread-only memory coupled to the processor; and a carriage interfacecoupled to the processor.
 7. The medication dispensing system, asrecited in claim 6 , further comprising means for transmitting a packetmessage.
 8. The medication dispensing system, as recited in claim 6 ,wherein the packet message receiving means further comprises: anantenna; an antenna switch coupled to the antenna; and a messagereceiver coupled to the antenna switch.
 9. The medication dispensingsystem, as recited in claim 1 , wherein the medication unit furthercomprises: a canister storing the medication; and a base medicationdispenser removably engaged with the canister.
 10. The medicationdispensing system, as recited in claim 1 , wherein the base medicationdispenser further comprises: a canister storing the medication; adelivery drum for receiving medication from the canister; a deliverydrum actuator coupled to the delivery drum; and a dispensing cavitydisposed proximate the delivery drum.
 11. The medication dispensingsystem, as recited in claim 10 , further comprising a carriage having acarriage circuit.
 12. The medication dispensing system, as recited inclaim 11 , wherein the carriage circuit further comprises: a powersource; a motor driver coupled to the power source; and means forcontrolling operation of the carriage.
 13. The medication dispensingsystem, as recited in claim 12 , wherein the carriage further comprises:a motor driven by the motor driver; and at least one gear rotated by themotor and rotatably coupled to the delivery drum actuator.
 14. Themedication dispensing system, as recited in claim 12 , wherein thecontrolling means further comprises a firmware controller.
 15. Themedication dispensing system, as recited in claim 12 , wherein thecontrolling means further comprises a carriage read-only memory storingdispensing operations.
 16. The medication dispensing system, as recitedin claim 11 , further comprising means for detecting a presence of themedication in the delivery drum.
 17. The medication dispensing system,as recited in claim 16 , wherein the detecting means further comprises:a first light pipe extending from a first entrance of the basemedication dispenser to a first end of the delivery drum; a second lightpipe extending from a second entrance of the base dispenser to a secondend of the delivery drum; and disposed within the base medicationdispenser; a first detector disposed on a surface of the carriageproximate the first entrance; and a second detector disposed on thesurface of the carriage proximate the second entrance.
 18. Themedication dispensing system, a recited in claim 10 , further comprisingmeans for detecting a type of medication stored in the canister.
 19. Themedication dispensing system, as recited in claim 18 , wherein themedication type detecting means further comprises: an identifying chipdisposed along a surface of the canister; and a chip detector disposedalong a surface of the carriage.
 20. A portable medication dispensingcontrol system adapted to be communicatively coupled to a medicationdispensing apparatus, the system comprising: means for storing adispensing control program, the dispensing control program controllingfunctions for: identifying a stored medication; comparing the identifiedmedication to a stored medication identifier; means, responsive to thedispensing control program, for providing a control signal to themedication dispensing apparatus.
 21. A medication container adapted foruse with an automated medication dispenser, the container comprising: ahollow housing for storing at least one medication, the housing having aplurality of sides; and means for storing medication information, thestoring means adapted to be interrogated by the medication dispenser,and the storing means being coupled to one of the sides.
 22. Themedication dispenser, as recited in claim 21 , wherein the storing meansfurther comprises a programmable silicon ID chip.
 23. The medicationdispenser, as recited in claim 21 , wherein the chip may be interrogatedwithout power.
 24. A method for automatically verifying and dispensing amedication, the method adapted for use with a container having means foridentifying a medication stored therein, the method comprising the stepsof: interrogating the identifying means for the medication stored in thecontainer; comparing the medication stored in the container to storedmedication information; and if the stored medication matches the storedmedication information, automatically dispensing at least one of thestored medication.